Department Analyst I – Credentialing
Cleveland Clinic
full-time
Posted on:
Location Type: Hybrid
Location: Cleveland • Ohio • United States
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Job Level
About the role
- Analyze and evaluate operational and financial functions of administrative and operational units
- Analyze departmental resources, services, systems, budgets and programs
- Prepare and develop special reports and recommendations based on analysis
- Conduct basic statistical analysis and evaluation of unit services and performance
- Identify program or service strengths, weaknesses, and financial impact
- Identify opportunities for service and program improvement
- Assist with the development of operational plans, procedures and systems
- Review and evaluate current procedures and systems and develop recommendations for improvement
- Maintain awareness of and comply with various regulatory guidelines (JCAHO, FDA, HIPAA, OSHA, etc.)
- Manage credentialing for CCF providers across multiple commercial health plans
- Ensure compliance with health plan credentialing criteria and delegated credentialing standards
- Perform primary source verification for licensure and credentials
- Maintain and update large provider rosters in Excel
- Meet tight deadlines (36–48 hours post-committee approval) for releasing providers to health plans
- Coordinate with internal teams to ensure accurate and timely credentialing
Requirements
- Bachelor’s Degree in Business, Healthcare Administration or a related field and one year of statistical analysis experience or five years of relevant experience in a health care setting
- High School Diploma/GED and five years of experience OR Associate's Degree and three years of experience OR Master's Degree
- Two years of commercial health plan credentialing experience OR medical staff office credentialing experience
- Excel proficiency: (filtering, sorting, find/replace, navigating large rosters)
- Understanding of credentialing criteria for health plans
- Knowledge of delegated credentialing vs. manual enrollment
- Knowledge of primary source verification processes
- Comfortable working in a fast-paced environment with large data sets
- Experience with credentialing processes and compliance standards
Benefits
- Outstanding, comprehensive offerings
- Investment in your health, well-being and future
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
statistical analysisExcel proficiencycredentialing processesprimary source verificationprogram evaluationoperational planningbudget analysisdata analysisregulatory complianceservice improvement
Soft skills
analytical skillscommunicationorganizational skillstime managementattention to detailproblem-solvingteam coordinationadaptabilityinterpersonal skillsdeadline management